1
|
Luo J, Hendryx M, Rohan TE, Saquib N, Shadyab AH, Su L, Hosgood D, Schnatz PF, Qi L, Anderson GL. Hysterectomy, oophorectomy and risk of non-Hodgkin's lymphoma. Int J Cancer 2024; 154:1433-1442. [PMID: 38112671 PMCID: PMC10922604 DOI: 10.1002/ijc.34820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/16/2023] [Accepted: 11/24/2023] [Indexed: 12/21/2023]
Abstract
Hysterectomy is associated with an increased risk for adverse health outcomes. However, its connection to the risk of non-Hodgkin's lymphoma (NHL) remains unclear. The aims of our study were to investigate the associations between hysterectomy, oophorectomy and risk of NHL and its major subtypes (eg, diffuse large B-cell lymphoma [DLBCL]), and whether these associations were modified by exogenous hormone use. Postmenopausal women (n = 141,621) aged 50-79 years at enrollment (1993-1998) from the Women's Health Initiative were followed for an average of 17.2 years. Hysterectomy and oophorectomy were self-reported at baseline. Incident NHL cases were confirmed by central review of medical records and pathology reports. During the follow-up period, a total of 1719 women were diagnosed with NHL. Hysterectomy, regardless of oophorectomy status, was associated with an increased risk of NHL (hazard ratio [HR] = 1.23, 95% confidence interval [CI]: 1.05-1.44). Oophorectomy was not independently associated with NHL risk after adjusting for hysterectomy. When stratified by hormone use, the association between hysterectomy and NHL risk was confined to women who had never used hormone therapy (HR = 1.35, 95% CI: 1.06-1.71), especially for DLBCL subtype (P for interaction = .01), and to those who had undergone hysterectomy before the age of 55. Our large prospective study showed that hysterectomy was a risk factor of NHL. Findings varied by hormone use. Future studies incorporating detailed information on the types and indications of hysterectomy may deepen our understanding of the mechanisms underlying DLBCL development and its potential interactions with hormone use.
Collapse
Affiliation(s)
- Juhua Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN
| | - Michael Hendryx
- Department of Environmental and Occupational Health, School of Public Health, Indiana University, Bloomington, IN
| | - Thomas E Rohan
- Epidemiology & Population Health, Albert Einstein College of Medicine. Bronx, NY
| | - Nazmus Saquib
- College of Medicine, Sulaiman AlRajhi University, Al Bukairiyah, Kingdom of Saudi Arabia
| | - Aladdin H. Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA
| | - Le Su
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN
| | - Dean Hosgood
- Epidemiology & Population Health, Albert Einstein College of Medicine. Bronx, NY
| | - Peter F. Schnatz
- Department of Obstetrics & Gynecology and Internal Medicine, Drexel University, West Reading, PA
| | - Lihong Qi
- Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA
| | - Garnet L Anderson
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., PO Box 19024, Seattle, WA
| |
Collapse
|
2
|
Melnik BC, Stadler R, Weiskirchen R, Leitzmann C, Schmitz G. Potential Pathogenic Impact of Cow’s Milk Consumption and Bovine Milk-Derived Exosomal MicroRNAs in Diffuse Large B-Cell Lymphoma. Int J Mol Sci 2023; 24:ijms24076102. [PMID: 37047075 PMCID: PMC10094152 DOI: 10.3390/ijms24076102] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/05/2023] [Accepted: 03/16/2023] [Indexed: 03/29/2023] Open
Abstract
Epidemiological evidence supports an association between cow’s milk consumption and the risk of diffuse large B-cell lymphoma (DLBCL), the most common non-Hodgkin lymphoma worldwide. This narrative review intends to elucidate the potential impact of milk-related agents, predominantly milk-derived exosomes (MDEs) and their microRNAs (miRs) in lymphomagenesis. Upregulation of PI3K-AKT-mTORC1 signaling is a common feature of DLBCL. Increased expression of B cell lymphoma 6 (BCL6) and suppression of B lymphocyte-induced maturation protein 1 (BLIMP1)/PR domain-containing protein 1 (PRDM1) are crucial pathological deviations in DLBCL. Translational evidence indicates that during the breastfeeding period, human MDE miRs support B cell proliferation via epigenetic upregulation of BCL6 (via miR-148a-3p-mediated suppression of DNA methyltransferase 1 (DNMT1) and miR-155-5p/miR-29b-5p-mediated suppression of activation-induced cytidine deaminase (AICDA) and suppression of BLIMP1 (via MDE let-7-5p/miR-125b-5p-targeting of PRDM1). After weaning with the physiological termination of MDE miR signaling, the infant’s BCL6 expression and B cell proliferation declines, whereas BLIMP1-mediated B cell maturation for adequate own antibody production rises. Because human and bovine MDE miRs share identical nucleotide sequences, the consumption of pasteurized cow’s milk in adults with the continued transfer of bioactive bovine MDE miRs may de-differentiate B cells back to the neonatal “proliferation-dominated” B cell phenotype maintaining an increased BLC6/BLIMP1 ratio. Persistent milk-induced epigenetic dysregulation of BCL6 and BLIMP1 expression may thus represent a novel driving mechanism in B cell lymphomagenesis. Bovine MDEs and their miR cargo have to be considered potential pathogens that should be removed from the human food chain.
Collapse
|
3
|
James ER, Miranda RN, Turner SD. Primary Lymphomas of the Breast: A Review. JPRAS Open 2022; 32:127-143. [PMID: 35402679 PMCID: PMC8987598 DOI: 10.1016/j.jpra.2022.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 01/10/2022] [Indexed: 11/06/2022] Open
Abstract
Lymphomas of the breast are rare neoplasms that arise from breast lymphoid tissue and are characterised by neoplastic B or T cells. Breast lymphomas arising from B cells include, but are not limited to, diffuse large B cell lymphoma, follicular lymphoma, extra-nodal marginal zone lymphoma and Burkitt lymphoma. Anaplastic large cell lymphoma (ALCL) is of a T cell origin and both anaplastic lymphoma kinase (ALK)-positive and ALK-negative presentations have been noted in the breast. In addition, there is a more recently identified presentation of ALK-negative ALCL that arises around textured breast implants and is usually confined to a periprosthetic fibrous capsule. Here, we discuss the clinical presentations, histological and immunohistochemical features and treatment options for each type of primary breast lymphoma. We hope that this review will highlight the importance of the timely and accurate diagnosis of breast lymphoma in order to tailor the most appropriate treatment. We also wish to raise awareness of the breast implant-associated lymphomas, with the goal of stimulating work that will aid our understanding of their epidemiology and pathogenesis.
Collapse
|
4
|
Chen X, Chen J, Liao S, Cao Y. Invasive ductal carcinoma and small lymphocytic lymphoma/chronic lymphocytic leukemia manifesting as a collision breast tumor: A case report and literature review. Open Life Sci 2021; 16:867-871. [PMID: 34522780 PMCID: PMC8402943 DOI: 10.1515/biol-2021-0093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/11/2021] [Accepted: 07/21/2021] [Indexed: 11/17/2022] Open
Abstract
Collision breast tumors, consisting of breast cancer (BC) and non-Hodgkin’s lymphoma (NHL), are extremely rare. Here we report the case of a 64-year-old woman with a collision tumor in her left breast mass that was composed of invasive ductal carcinoma and small lymphocytic lymphoma/chronic lymphocytic leukemia. In addition, we reviewed the published comparable English-language literature. Collision breast tumor composed of BC and NHL is extremely rare. For that reason, there is a lack of consensus about the underlying mechanism, and diagnosing it without delay remains a complex clinical challenge. We found that post-menopausal, age-related estrogen levels changes and Epstein-Barr virus infection are possible pathogenic factors. However, the symptoms are almost identical, and it is difficult to distinguish a simple breast tumor from a breast collision tumor. In this study, we reviewed the clinical features of all patients with BC and NHL colliding breast tumors; this information might enable early identification and prevention of misdiagnosis.
Collapse
Affiliation(s)
- Xiaowen Chen
- Department of Oncology Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Jianli Chen
- The Third Department of Medical Oncology, The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China
| | - Sihai Liao
- Department of Oncology Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Yuwen Cao
- Department of Pathology, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| |
Collapse
|
5
|
Chen M, Zhou J, Qu X. Primary Breast Diffuse Large B-Cell Lymphoma in a 42-Year-Old Female: A Case Report and Review of Literature. J Med Cases 2021; 12:181-185. [PMID: 34434454 PMCID: PMC8383536 DOI: 10.14740/jmc3660] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 02/08/2021] [Indexed: 11/11/2022] Open
Abstract
Primary breast diffuse large B-cell lymphoma (PB-DLBCL) is a rare localized extranodal lymphoma. It is mainly diagnosed by pathological examination due to the lack of specific clinical and imaging manifestations. Whole-body positron emission tomography-computed tomography (PET-CT) is widely used in determining clinical staging and guiding clinical treatment. As part of comprehensive treatment, targeted therapy with rituximab, intrathecal methotrexate injection and consolidation radiotherapy remain controversial in treating PB-DLBCL, but the comprehensive treatment based on full-course of chemotherapy is still widely used as the first-line treatment. Comprehensive treatment often leads to a sharp decline in the immunity of elderly patients with malignancy. In this situation, surgery may be a good chance to improve their life quality without serious complications. We present a rare case of PB-DLBCL during the coronavirus disease 2019 (COVID-19) pandemic. The patient underwent chest CT scan to screen COVID-19 and a mass of left breast was accidentally found. Because of the city lockdown policy in Wuhan, she did not seek medical help until noticing that the mass was gradually enlarged. Both ultrasonography and mammography indicated that the lesion was breast cancer. However, ultrasound-guided core needle biopsy revealed diffuse large B-cell lymphoma of breast and PET-CT scan showed that the lesion was a primary hypermetabolic tumor of left breast. The patient subsequently received comprehensive treatment based on six cycles of rituximab-cyclophosphamide, hydroxydaunomycin, oncovin, prednisone (R-CHOP) chemotherapy.
Collapse
Affiliation(s)
- Maolin Chen
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - Jun Zhou
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - Xincai Qu
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji College, Huazhong University of Science and Technology, Wuhan 430000, China
| |
Collapse
|
6
|
Abstract
This retrospective study aimed to improve the diagnostic accuracy of breast lymphoma (BL) by analyzing the findings of BL on mammography and magnetic resonance imaging (MRI).Fifteen patients with breast lymphoma (BL, Primary/Secondary: 13/2) were confirmed by pathology. The imaging findings of those patients were analyzed by 2 senior radiologists.BL commonly showed significant enhancement with penetrating vessels and septation in masses on dynamic contrast-enhanced MRI (DCE-MRI). Diffusion limitation of BL is more pronounced than breast cancer on diffusion weighted imaging.The study suggests that the penetrating vessels and diffusion restriction of lesions are helpful for the diagnosis and differential diagnosis of BL.
Collapse
Affiliation(s)
- Changyu Zhou
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University
| | - Kun Lv
- Department of Ultrasound Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Dongya Lin
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University
| | - Yinxing Yu
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University
| | - Maosheng Xu
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University
| | - Yangyang Bu
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University
| |
Collapse
|
7
|
Costas L, Lujan-Barroso L, Benavente Y, Allen NE, Amiano P, Ardanaz E, Besson C, Boeing H, Bueno-de-Mesquita B, Cervenka I, Fortner RT, Fournier A, Gunter M, Harlid S, Huerta JM, Jerkeman M, Jirström K, Kaaks R, Karakatsani A, Khaw KT, Kotanidou A, Lund E, Masala G, Mattiello A, Melin B, Menéndez V, Murphy N, Nieters A, Overvad K, Riboli E, Sacerdote C, Sánchez MJ, Schmidt JA, Sieri S, Tjønneland A, Trichopoulou A, Tumino R, Vermeulen R, Weiderpass E, de Sanjosé S, Agudo A, Casabonne D. Reproductive Factors, Exogenous Hormone Use, and Risk of B-Cell Non-Hodgkin Lymphoma in a Cohort of Women From the European Prospective Investigation Into Cancer and Nutrition. Am J Epidemiol 2019; 188:274-281. [PMID: 30481275 PMCID: PMC6357796 DOI: 10.1093/aje/kwy259] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 11/16/2018] [Accepted: 11/16/2018] [Indexed: 12/24/2022] Open
Abstract
The role of hormonal factors in the etiology of lymphoid neoplasms remains unclear. Previous studies have yielded conflicting results, have lacked sufficient statistical power to assess many lymphoma subtypes, or have lacked detailed information on relevant exposures. Within the European Prospective Investigation Into Cancer and Nutrition cohort, we analyzed comprehensive data on reproductive factors and exogenous hormone use collected at baseline (1992-2000) among 343,458 women, including data on 1,427 incident cases of B-cell non-Hodgkin lymphoma (NHL) and its major subtypes identified after a mean follow-up period of 14 years (through 2015). We estimated hazard ratios and 95% confidence intervals using multivariable proportional hazards modeling. Overall, we observed no statistically significant associations between parity, age at first birth, breastfeeding, oral contraceptive use, or ever use of postmenopausal hormone therapy and risk of B-cell NHL or its subtypes. Women who had undergone surgical menopause had a 51% higher risk of B-cell NHL (based on 67 cases) than women with natural menopause (hazard ratio = 1.51, 95% confidence interval: 1.17, 1.94). Given that this result may have been due to chance, our results provide little support for the hypothesis that sex hormones play a role in lymphomagenesis.
Collapse
Affiliation(s)
- Laura Costas
- Unit of Molecular Epidemiology and Genetics in Infections and Cancer, Cancer Epidemiology Research Programme, Bellvitge Biomedical Research Institute, Catalan Institute of Oncology, L’Hospitalet de Llobregat, Spain
| | - Leila Lujan-Barroso
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Bellvitge Biomedical Research Institute, Catalan Institute of Oncology, L’Hospitalet de Llobregat, Spain
- Department of Nursing of Public Health, Mental Health and Maternity and Child Health, School of Nursing, Universitat de Barcelona, Barcelona, Spain
| | - Yolanda Benavente
- Unit of Molecular Epidemiology and Genetics in Infections and Cancer, Cancer Epidemiology Research Programme, Bellvitge Biomedical Research Institute, Catalan Institute of Oncology, L’Hospitalet de Llobregat, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
| | - Naomi E Allen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
| | - Pilar Amiano
- Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
- Public Health Division of Gipuzkoa, BioDonostia Health Research Institute, San Sebastian, Spain
| | - Eva Ardanaz
- Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
| | - Caroline Besson
- Unit of Hematology-Oncology, Centre Hospitalier de Versailles, Le Chesnay, France
- Centre de Recherche en Epidémiologie et Santé des Populations, Faculté de Médecine–Université Paris-Sud and Faculté de Médecine–Université de Versailles Saint-Quentin-en-Yvelines, Institut National de la Santé et de la Recherche Médicale, Université Paris-Saclay, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
| | - Heiner Boeing
- German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Bas Bueno-de-Mesquita
- Department of Determinants of Chronic Diseases, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, the Netherlands
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary’s Campus, London, United Kingdom
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Iris Cervenka
- Centre de Recherche en Epidémiologie et Santé des Populations, Faculté de Médecine–Université Paris-Sud and Faculté de Médecine–Université de Versailles Saint-Quentin-en-Yvelines, Institut National de la Santé et de la Recherche Médicale, Université Paris-Saclay, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
| | - Renée T Fortner
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Agnès Fournier
- Centre de Recherche en Epidémiologie et Santé des Populations, Faculté de Médecine–Université Paris-Sud and Faculté de Médecine–Université de Versailles Saint-Quentin-en-Yvelines, Institut National de la Santé et de la Recherche Médicale, Université Paris-Saclay, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
| | - Marc Gunter
- International Agency for Research on Cancer, Lyon, France
| | - Sophia Harlid
- Department of Radiation Sciences, Oncology, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - José María Huerta
- Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, Instituto Murciano de Investigación Biosanitaria-Arrixaca, Murcia, Spain
| | - Mats Jerkeman
- Division of Oncology and Pathology, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Karin Jirström
- Division of Oncology and Pathology, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Anna Karakatsani
- Hellenic Health Foundation, Athens, Greece
- Department of Pulmonary Medicine, School of Medicine, National and Kapodistrian University of Athens, Attikon University General Hospital, Haidari, Greece
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Anastasia Kotanidou
- Hellenic Health Foundation, Athens, Greece
- Department of Critical Care Medicine and Pulmonary Services, University of Athens Medical School, Evangelismos Hospital, Athens, Greece
| | - Eiliv Lund
- Department of Community Medicine, The Arctic University of Norway, Tromsø, Norway
| | - Giovanna Masala
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | - Amalia Mattiello
- Dipartimento di Medicina Clinica e Chirugia, Federico II University, Naples, Italy
| | - Beatrice Melin
- Department of Radiation Sciences, Oncology, Faculty of Medicine, Umeå University, Umeå, Sweden
| | | | - Neil Murphy
- International Agency for Research on Cancer, Lyon, France
| | - Alexandra Nieters
- Center for Chronic Immunodeficiency at the Center for Translational Cell Research, University of Freiburg Medical Center, Freiburg, Germany
| | - Kim Overvad
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention, Turin, Italy
| | - Maria-Jose Sánchez
- Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria de Granada, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - Julie A Schmidt
- Cancer Epidemiology Unit, Nuffield Department of Population Health, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
| | - Sabina Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS-Istituto Nazionale dei Tumori, Milano, Italy
| | - Anne Tjønneland
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | - Rosario Tumino
- Cancer Registry and Histopathology Department, Maria Paternò Arezzo Hospital, Ragusa, Italy
| | - Roel Vermeulen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Elisabete Weiderpass
- Department of Community Medicine, The Arctic University of Norway, Tromsø, Norway
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | | | - Antonio Agudo
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Bellvitge Biomedical Research Institute, Catalan Institute of Oncology, L’Hospitalet de Llobregat, Spain
| | - Delphine Casabonne
- Unit of Molecular Epidemiology and Genetics in Infections and Cancer, Cancer Epidemiology Research Programme, Bellvitge Biomedical Research Institute, Catalan Institute of Oncology, L’Hospitalet de Llobregat, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
| |
Collapse
|
8
|
Varelas AN, Eggerstedt M, Ganti A, Tajudeen BA. Epidemiologic, prognostic, and treatment factors in sinonasal diffuse large B -cell lymphoma. Laryngoscope 2018; 129:1259-1264. [PMID: 30570148 DOI: 10.1002/lary.27639] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 08/16/2018] [Accepted: 09/04/2018] [Indexed: 01/16/2023]
Abstract
OBJECTIVES To further characterize the epidemiology, prognostic disease-specific factors, and treatment outcomes-including newly available chemotherapy data-for patients with sinonasal diffuse large B-cell lymphoma (DLBCL). METHODS The Surveillance, Epidemiology, and End Results registry was queried from 1973 to 2015 for patients with DLBCL of the nasal cavity and paranasal sinuses. Demographic and disease parameters were collected. Prognostic disease-specific survival and overall survival factors were evaluated with univariate Kaplan-Meier analysis. Significant variables were analyzed with multivariate Cox regression analysis. RESULTS A total of 1,273 cases of DLBCL of the sinonasal tract were identified. Significant differences in age of diagnosis between men (65.3) and women (71.1) existed (P < .01). Most common primary sites of DLBCL were maxillary sinus (36.1%) and nasal cavity (34.5%), with nasal cavity more common among Asian/Pacific Islands (43.4%) and maxillary sinus more common for Caucasians (36.3%) and African Americans (42.1%). Overall survival was 70% at 2 years, 54% at 5 years, and 38% at 10 years. Disease-specific survival was 81%, 73%, and 67%, respectively. Chemotherapy (hazard ratio [HR]: 0.551; P < .001) and radiation therapy (HR: 0.818; P = .012) were associated with improved prognosis, whereas higher Ann Arbor stage worsened prognosis (HR: 1.21; P < .001). Surgical intervention did not significantly impact survival. CONCLUSION This is the first study to include chemoradiation therapy in population-based analysis of sinonasal DLBCL. Chemotherapy and radiation therapy use significantly improve survival in these patients, whereas Ann Arbor staging is significantly associated with poorer outcomes. The mainstay of treatment for DLBCL should remain combination chemoradiation. LEVEL OF EVIDENCE NA Laryngoscope, 129:1259-1264, 2019.
Collapse
Affiliation(s)
- Antonios N Varelas
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Michael Eggerstedt
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Ashwin Ganti
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Bobby A Tajudeen
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| |
Collapse
|
9
|
Hosgood HD, Gunter MJ, Murphy N, Rohan TE, Strickler HD. The Relation of Obesity-Related Hormonal and Cytokine Levels With Multiple Myeloma and Non-Hodgkin Lymphoma. Front Oncol 2018; 8:103. [PMID: 29713614 PMCID: PMC5911620 DOI: 10.3389/fonc.2018.00103] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 03/23/2018] [Indexed: 12/19/2022] Open
Abstract
This article presents the first detailed overview of the mechanisms that may underlie the relation of obesity with B-cell non-Hodgkin lymphomas (NHLs) and multiple myeloma (MM). Epidemiologic studies, including meta-analyses of prospective cohorts, have reported that the risks of NHL and MM are significantly increased in obese, relative to normal weight, women and men. Accumulating experimental and clinical evidence suggests that inflammatory cytokines, hyperinsulinemia, and sex hormones could play a role in the association of obesity with B-cell NHL and MM carcinogenesis. There is, however, a paucity of data published from appropriate large prospective cohort studies, and studies concurrently measuring these correlated factors, to formally determine the likely biologic factors driving the relationship of obesity with NHL and MM. Additional strengths and weaknesses of the current literature, as well as study design issues that need to be considered in conducting these studies, such as the exclusion of type 2 diabetics or postmenopausal women using hormone therapy, are discussed.
Collapse
Affiliation(s)
- H Dean Hosgood
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Marc J Gunter
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Neil Murphy
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Howard D Strickler
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| |
Collapse
|
10
|
Jia Y, Sun C, Liu Z, Wang W, Zhou X. Primary breast diffuse large B-cell lymphoma: a population-based study from 1975 to 2014. Oncotarget 2018; 9:3956-3967. [PMID: 29423097 PMCID: PMC5790514 DOI: 10.18632/oncotarget.23285] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 09/20/2017] [Indexed: 11/25/2022] Open
Abstract
Primary breast diffuse large B-cell lymphoma (DLBCL) is a rare non-Hodgkin's lymphoma with limited data. In this study, a population-based study of primary breast DLBCL in the United States was performed to determine its incidence trends, prognostic factors, survival, the role of surgery as well as the comparison with nodal DLBCL. 1021 patients diagnosed with breast DLBCL were identified in the Surveillance, Epidemiology, and End Results (SEER) cancer registries from 1973-2014. The incidence of both breast and nodal DLBCL increased over time. Patients with breast DLBCL were older, mainly women, diagnosed at earlier stages and had lower prevalence in white and black races compared with nodal DLBCL. Multivariate analysis revealed older age (≥ 70 years old) and advanced stage as independent predictors of worse OS. Independent predictor of better DSS were younger age (< 70 years old), early stage and diagnosis after 2000. When analyzed according to age, stage, race, tumor laterality and year of diagnosis, the overall survival did not benefit from surgery except in patients diagnosed between 2001-2010 and the surgery rate decreased overtime. Compared with nodal DLBCL, breast DLBCL patients exhibited a better outcome. In conclusion, breast DLBCL is a rare tumor with increasing incidence and improved survival over the last four decades. The introduction of rituximab seems to improve the outcome of breast DLBCL. Further studies are needed to advance our understanding of breast DLBCL and optimize the treatment strategy.
Collapse
Affiliation(s)
- Yijun Jia
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.,Institute of Pathology, Fudan University, Shanghai 200032, China
| | - Chenbo Sun
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.,Institute of Pathology, Fudan University, Shanghai 200032, China
| | - Zebing Liu
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.,Institute of Pathology, Fudan University, Shanghai 200032, China.,Department of Pathology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Weige Wang
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.,Institute of Pathology, Fudan University, Shanghai 200032, China
| | - Xiaoyan Zhou
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.,Institute of Pathology, Fudan University, Shanghai 200032, China
| |
Collapse
|
11
|
Osman MH, Farrag E, Selim M, Osman MS, Hasanine A, Selim A. Cardiac glycosides use and the risk and mortality of cancer; systematic review and meta-analysis of observational studies. PLoS One 2017; 12:e0178611. [PMID: 28591151 PMCID: PMC5462396 DOI: 10.1371/journal.pone.0178611] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 05/16/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Cardiac glycosides (CGs) including digitalis, digoxin and digitoxin are used in the treatment of congestive heart failure and atrial fibrillation. Pre-clinical studies have investigated the anti-neoplastic properties of CGs since 1960s. Epidemiological studies concerning the association between CGs use and cancer risk yielded inconsistent results. We have performed a systematic review and meta-analysis to summarize the effects of CGs on cancer risk and mortality. METHODS PubMed, Scopus, Cochrane library, Medline and Web of Knowledge were searched for identifying relevant studies. Summary relative risks (RR) and 95% confidence intervals (CI) were calculated using random-effects model. RESULTS We included 14 case-control studies and 15 cohort studies published between 1976 and 2016 including 13 cancer types. Twenty-four studies reported the association between CGs and cancer risk and six reported the association between CGs and mortality of cancer patients. Using CGs was associated with a higher risk of breast cancer (RR = 1.330, 95% CI: 1.247-1.419). Subgroup analysis showed that using CGs increased the risk of ER+ve breast cancer but not ER-ve. Using CGs wasn't associated with prostate cancer risk (RR = 1.015, 95% CI: 0.868-1.87). However, CGs decreased the risk in long term users and showed a protective role in decreasing the risk of advanced stages. CGs use was associated with increased all-cause mortality (HR = 1.35, 95% CI: 1.248-1.46) but not cancer-specific mortality (HR = 1.075, 95% CI: 0.968-1.194). CONCLUSION The anti-tumor activity of CGs observed in pre-clinical studies requires high concentrations which can't be normally tolerated in humans. However, the estrogen-like activity of CGs could be responsible for increasing the risk of certain types of tumors.
Collapse
Affiliation(s)
| | - Eman Farrag
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mai Selim
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | | | - Arwa Hasanine
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Azza Selim
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| |
Collapse
|
12
|
Affiliation(s)
| | - Eva Kassi
- Deparment of Biological Chemistry, Medical Scholl, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
13
|
Kuhle CL, Kapoor E, Sood R, Thielen JM, Jatoi A, Faubion SS. Menopausal hormone therapy in cancer survivors: A narrative review of the literature. Maturitas 2016; 92:86-96. [PMID: 27621244 DOI: 10.1016/j.maturitas.2016.07.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 07/21/2016] [Accepted: 07/26/2016] [Indexed: 12/25/2022]
Abstract
Decision making regarding the use of menopausal hormone therapy (MHT) for the treatment of bothersome menopausal symptoms in a cancer survivor can be complex, and includes assessment of its impact on disease-free or overall survival. Estrogen receptors are present in several cancer types, but this does not always result in estrogen-mediated tumor proliferation and adverse cancer-related outcomes. Estrogen may even be protective against certain cancers. Menopausal hormone therapy is associated with an increased risk of recurrence and mortality after diagnosis of some cancer types, but not others. We provide a narrative review of the medical literature regarding the risk of cancer recurrence and associated mortality with initiation of MHT after the diagnosis of breast, gynecologic, lung, colorectal, hematologic cancers, and melanoma. Menopausal hormone therapy may be considered for management of bothersome menopausal symptoms in women with some cancer types (e.g., colorectal and hematologic cancer, localized melanoma, and most cervical, vulvar and vaginal cancers), while nonhormonal treatment options may be preferred for others (e.g., breast cancer). In women with other cancer types, recommendations are less straightforward, and the use of MHT must be individualized.
Collapse
Affiliation(s)
- Carol L Kuhle
- Women's Health Clinic, Division of General Internal Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States.
| | - Ekta Kapoor
- Women's Health Clinic, Division of General Internal Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States; Division of Endocrinology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States
| | - Richa Sood
- Women's Health Clinic, Division of General Internal Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States
| | - Jacqueline M Thielen
- Women's Health Clinic, Division of General Internal Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States
| | - Aminah Jatoi
- Division of Medical Oncology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States
| | - Stephanie S Faubion
- Women's Health Clinic, Division of General Internal Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States
| |
Collapse
|
14
|
Ishibashi N, Hata M, Mochizuki T, Ogawa K, Sugiura H, Takekawa Y, Maebayashi T, Aizawa T, Sakaguchi M, Abe O. Radiation therapy for primary breast lymphoma in male gynecomastia: a rare case report and review of the literature. Int J Hematol 2016; 104:519-24. [DOI: 10.1007/s12185-016-2026-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Revised: 05/17/2016] [Accepted: 05/17/2016] [Indexed: 01/18/2023]
|
15
|
Kato I, Chlebowski RT, Hou L, Wactawski-Wende J, Ray RM, Abrams J, Bock C, Desai P, Simon MS. Menopausal estrogen therapy and non-Hodgkin's lymphoma: A post-hocanalysis of women's health initiative randomized clinical trial. Int J Cancer 2016; 138:604-11. [DOI: 10.1002/ijc.29819] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 08/14/2015] [Indexed: 12/19/2022]
Affiliation(s)
- Ikuko Kato
- Department of Oncology; Wayne State University School of Medicine; Detroit MI
- Department of Pathology; Wayne State University School of Medicine; Detroit MI
| | - Rowan T. Chlebowski
- Division of Medical Oncology and Hematology, Department of Medicine; Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angels Medical Center; Torrance CA
| | - Lifang Hou
- Department of Preventive Medicine and the Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine; Northwestern University; Evanston IL
| | - Jean Wactawski-Wende
- Departments of Epidemiology and Environmental Health; University of Buffalo; Buffalo NY
| | - Roberta M. Ray
- Division of Public Health Sciences; Fred Hutchinson Cancer Research Center; Seattle WA
| | - Judith Abrams
- Department of Oncology; Wayne State University School of Medicine; Detroit MI
| | - Cathryn Bock
- Department of Oncology; Wayne State University School of Medicine; Detroit MI
| | - Pinkal Desai
- Division of Hematology and Oncology, Department of Medicine; Weill Cornell Medical College; New York NY
| | - Michael S Simon
- Department of Oncology; Wayne State University School of Medicine; Detroit MI
| |
Collapse
|
16
|
Costas L, Lambert BH, Birmann BM, Moysich KB, De Roos AJ, Hofmann JN, Baris D, Wang SS, Camp NJ, Tricot G, Atanackovic D, Brennan P, Cocco P, Nieters A, Becker N, Maynadié M, Foretová L, Boffetta P, Staines A, Brown EE, de Sanjosé S. A Pooled Analysis of Reproductive Factors, Exogenous Hormone Use, and Risk of Multiple Myeloma among Women in the International Multiple Myeloma Consortium. Cancer Epidemiol Biomarkers Prev 2016; 25:217-21. [PMID: 26464426 PMCID: PMC4745255 DOI: 10.1158/1055-9965.epi-15-0953] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 09/25/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Female sex hormones are known to have immunomodulatory effects. Therefore, reproductive factors and exogenous hormone use could influence the risk of multiple myeloma in women. However, the role of hormonal factors in multiple myeloma etiology remains unclear because previous investigations were underpowered to detect modest associations. METHODS We conducted a pooled analysis of seven case-control studies included in the International Multiple Myeloma Consortium, with individual data on reproductive factors and exogenous hormone use from 1,072 female cases and 3,541 female controls. Study-specific odds ratios and corresponding 95% confidence intervals (CI) were estimated using logistic regression and pooled analyses were conducted using random effects meta-analyses. RESULTS Multiple myeloma was not associated with reproductive factors, including ever parous [OR = 0.92; 95% confidence interval (CI), 0.68-1.25], or with hormonal contraception use (OR = 1.04; 95% CI, 0.80-1.36). Postmenopausal hormone therapy users had nonsignificantly reduced risks of multiple myeloma compared with never users, but this association differed across centers (OR = 0.65; 95% CI, 0.37-1.15, I(2) = 76.0%, Pheterogeneity = 0.01). CONCLUSIONS These data do not support a role for reproductive factors or exogenous hormones in myelomagenesis. IMPACT Incidence rates of multiple myeloma are higher in men than in women, and sex hormones could influence this pattern. Associations with reproductive factors and exogenous hormone use were inconclusive despite our large sample size, suggesting that female sex hormones may not play a significant role in multiple myeloma etiology.
Collapse
Affiliation(s)
- Laura Costas
- Unit of Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain. Department of Medicine, University of Barcelona, Barcelona, Spain. CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain.
| | - Brice H Lambert
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Brenda M Birmann
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Kirsten B Moysich
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York
| | - Anneclaire J De Roos
- Department of Environmental and Occupational Health, Drexel University School of Public Health, Philadelphia, Pennsylvania
| | - Jonathan N Hofmann
- Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Rockville, Maryland
| | - Dalsu Baris
- Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Rockville, Maryland
| | - Sophia S Wang
- Division of Cancer Etiology, Department of Population Sciences, City of Hope and Beckman Research Institute, Duarte, California
| | - Nicola J Camp
- Division of Hematology and Hematologic Malignancies, University of Utah School of Medicine and Huntsman Cancer Institute, Salt Lake City, Utah
| | - Guido Tricot
- Department of Internal Medicine, University of Iowa, Iowa City, Iowa
| | - Djordje Atanackovic
- Division of Hematology and Hematologic Malignancies, University of Utah School of Medicine and Huntsman Cancer Institute, Salt Lake City, Utah
| | - Paul Brennan
- IARC, International Agency for Research on Cancer, Lyon, France
| | - Pierluigi Cocco
- Department of Public Health, Clinical and Molecular Medicine, Occupational Health Section, University of Cagliari, Cagliari, Italy
| | - Alexandra Nieters
- Center for Chronic Immunodeficiency, Molecular Epidemiology, University Medical Center Freiburg, Freiburg, Germany
| | - Nikolaus Becker
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Marc Maynadié
- Biological Hematology Unit, CRB Ferdinand Cabanne, Universitary Hospital of Dijon and EA4184, University of Burgundy, Dijon, France
| | - Lenka Foretová
- Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute and MF MU, Brno, Czech Republic
| | - Paolo Boffetta
- Tisch Cancer Institute and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Elisabeth E Brown
- Department of Pathology, University of Alabama at Birmingham, University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama
| | - Silvia de Sanjosé
- Unit of Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain. Department of Medicine, University of Barcelona, Barcelona, Spain. CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| |
Collapse
|
17
|
Leal AD, Thompson CA, Wang AH, Vierkant RA, Habermann TM, Ross JA, Mesa RA, Virnig BA, Cerhan JR. Hormonal and Reproductive Factors and Risk of Myeloproliferative Neoplasms in Postmenopausal Women. Cancer Epidemiol Biomarkers Prev 2015; 25:151-7. [PMID: 26564251 DOI: 10.1158/1055-9965.epi-15-0613] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 11/04/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Hormonal and reproductive history has been associated with risk of some hematologic malignancies, but their role in myeloproliferative neoplasms (MPN) is largely unknown. METHODS Using a population-based cohort study, we evaluated the association of these factors with risk of MPN overall, and for essential thrombocythemia (ET) and polycythemia vera (PV) specifically. Incident MPN cases from 1993 to 2004 were identified via linkage to Medicare. RR and 95% confidence intervals (CI) were estimated utilizing Cox proportional hazard regression. RESULTS After >250,000 person-years of follow-up, 257 cases of MPN were identified (172 ET, 64 PV). Ever use of hormone therapy (HT) was associated with an increased risk of ET (RR = 1.63; 95% CI, 1.19-2.23) but a decreased risk of PV (RR = 0.58; 95% CI, 0.34-0.98). There were no statistically significant associations of oral contraceptives or reproductive factors with MPN risk overall, or by MPN subtype. Bilateral oophorectomy was associated with increased risk of ET (RR = 1.58; 95% CI, 1.11-2.25) and decreased risk of PV (RR = 0.32; 95% CI, 0.12-0.88). There was no association of ovulatory years with ET risk; however, there was increased risk of PV (RR = 1.68 for >36.8 compared with ≤27.6 years; P trend = 0.045). Adjustment for potential confounding factors did not alter these associations. CONCLUSIONS HT use and bilateral oophorectomy had opposite associations for ET and PV. Except for ovulatory years and PV risk, reproductive history did not appear to play a role in the etiology of MPN. IMPACT This study suggests different mechanistic impacts of estrogen, and perhaps distinct etiologies, for the two major MPN subtypes.
Collapse
Affiliation(s)
- Alexis D Leal
- Division of Hematology, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Carrie A Thompson
- Division of Hematology, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Alice H Wang
- Divison of Biomedical Statistics and Informatics, College of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Robert A Vierkant
- Divison of Biomedical Statistics and Informatics, College of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Thomas M Habermann
- Division of Hematology, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Julie A Ross
- Division of Epidemiology and Clinical Research, Department of Pediatrics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Ruben A Mesa
- Division of Hematology and Medical Oncology, Mayo Clinic, Scottsdale, Arizona
| | - Beth A Virnig
- Division of Health Services Research and Policy, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - James R Cerhan
- Division of Epidemiology, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, Minnesota.
| |
Collapse
|
18
|
Zhang JQ, Geng H, Ma M, Nan XY, Sheng BW. Metabolic Syndrome Components are Associated with Increased Prostate Cancer Risk. Med Sci Monit 2015; 21:2387-96. [PMID: 26275075 PMCID: PMC4548704 DOI: 10.12659/msm.893442] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background Our study investigated the associations of metabolic syndrome (MS) and metabolic indicators with prostate cancer (PCa) risk in the Chinese Han ethnic population. Material/Methods We studied 101 PCa patients (without/with MS) and 120 healthy controls. Clinical data, including waist circumference, BMI, TG, FINS, FBG, and PCa-related indicators, were collected. The correlations between MS and PCa were analyzed. Results Compared to PCa, PV and Gleason scores increased and PSA levels decreased in PCa with MS group (all P<0.001). PV was positively correlated with BMI, FINS, and HOMA-IR (r=0.459, P<0.001; r=0.421, P=0.001; r=0.490, P=0.003, respectively), and was negatively correlated with HDL-C (r=−0.378, P<0.001). PSA level in MS patients was negatively correlated with BMI (r=−0.125, P<0.001), TG (r=−0.256, P<0.001) and FBG (r=−0.183, P<0.001). Large PV, high TG, low HDL-C, high LDL-C, and high FBG were associated with an increased risk of PCa (P<0.001, OR=1.10, 95%CI: 1.009–3.304; P<0.001, OR=2.91, 95%CI: 1.612–5.241; P<0.001, OR=7.89, 95%CI: 3.908–15.947; P=0.015, OR=1.87, 95%CI: 1.131–3.077; P=0.004, OR=2.17, 95%CI: 1.280–3.686, respectively). MS-related indicators showed a positive relationship with PCa (P<0.001, OR=1.90, 95%CI: 1.107–10.629). Conclusions Our study shows that MS and metabolic indicators are associated with an increased risk of PCa, pointing to a novel therapeutic approach for PCa management.
Collapse
Affiliation(s)
- Jian-Qin Zhang
- Department of Nutrition, The First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, Shaanxi, China (mainland)
| | - Hui Geng
- Health Examination Center, The First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, Shaanxi, China (mainland)
| | - Mao Ma
- Department of Geriatric Surgery, The First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, Shaanxi, China (mainland)
| | - Xun-Yi Nan
- Urology Institute, Xi'an Jiaotong University, Xi'an, Shaanxi, China (mainland)
| | - Bin-Wu Sheng
- Department of Geriatric Surgery, The First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, Shaanxi, China (mainland)
| |
Collapse
|
19
|
Shao YB, Sun XF, He YN, Liu CJ, Liu H. Clinicopathological features of thirty patients with primary breast lymphoma and review of the literature. Med Oncol 2015; 32:448. [PMID: 25572809 DOI: 10.1007/s12032-014-0448-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Accepted: 12/09/2014] [Indexed: 10/24/2022]
Abstract
Primary breast lymphoma (PBL) is a rare disease accounting for 0.4-0.5 % of all breast malignancies. Accumulating evidence indicates that the diagnosis, prognostic factors, and optimal management of PBL are difficult. The present study aims to investigate the clinicopathological features and optimal treatment of PBL and to evaluate the institutional experience in this patient population. A total of 30 patients with PBL from January 2002 to December 2012 treated in He'nan Province Tumor Hospital were selected. The patients' clinical and pathological characteristics, treatment and response data, patterns of recurrence, and outcomes were retrospectively analyzed, and the relevant literatures were reviewed. All the cases were female, and the median age was 45. Diffuse large B cell lymphoma was the most common histological subtype seen in 23 of 30 patients. With a median follow-up time 32 months, median OS was 42 months (95 % CI 25-58 months), with 5-year OS rates 48 % (95 % CI 36-59 %). The median PFS was 14 months (95 % CI 6-30 months), with 5-year PFS rates 32 % (95 % CI 20-45 %). The prognostic factors that retained statistical significance for OS were IPI (P < 0.001), age (P = 0.04), and stage (P < 0.001). For PFS, significant prognostic factors were IPI (P = 0.01), radiotherapy given (P = 0.02) and stage (P = 0.02). PBL appears to have a worse prognosis. The present treatment method for PBL is a comprehensive way of diagnostic surgery together with radiotherapy and chemotherapy.
Collapse
Affiliation(s)
- Y B Shao
- Department of Breast Oncology, The Affiliated Cancer Hospital of Zhengzhou University, 127 Dongming Road, Zhengzhou, 450008, China
| | | | | | | | | |
Collapse
|
20
|
Costas L, de Sanjosé S, Infante-Rivard C. Reproductive factors and non-Hodgkin lymphoma: a systematic review. Crit Rev Oncol Hematol 2014; 92:181-93. [PMID: 25132165 DOI: 10.1016/j.critrevonc.2014.07.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 05/08/2014] [Accepted: 07/23/2014] [Indexed: 02/07/2023] Open
Abstract
Considerable efforts have been made to elucidate non-Hodgkin lymphoma's (NHL) etiology during the last decades. Some evidence points to an association with reproductive factors, as incidence rates for most NHL subtypes are usually higher in men than in women, and several subtypes express hormonal receptors. Although the evidence is not compelling, some studies show an inverse association with gravidity. Associations with postmenopausal hormone therapy are usually derived from unopposed estrogen use, rather than for the combination of estrogen with progestin, but these findings vary by study design. Inconsistencies in the results are likely due to the complex relationship between reproductive, biological, and sociodemographic factors, as well as to study limitations. Elucidating the role of hormonal factors should provide clues for therapeutic options and public health decisions. We provide an overview of the available evidence on reproductive factors in NHL etiology, underscoring potential sources of discrepancies and bias.
Collapse
Affiliation(s)
- Laura Costas
- Unit of Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain; Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Canada.
| | - Silvia de Sanjosé
- Unit of Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - Claire Infante-Rivard
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Canada
| |
Collapse
|
21
|
Primary breast lymphoma. Cancer Treat Rev 2014; 40:900-8. [PMID: 24953564 DOI: 10.1016/j.ctrv.2014.05.010] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 05/22/2014] [Accepted: 05/26/2014] [Indexed: 01/01/2023]
Abstract
Primary breast lymphoma is a rare form of extranodal lymphoma, defined by the presence of a primary lesion within the breast with or without regional nodal involvement but no other extra-mammary sites of involvement. It comprises diverse histologic subtypes, but diffuse large B-cell lymphoma is the most common. In this review, we describe in detail the clinical features, diagnosis and staging, pathogenesis, risk factors and therapy of primary breast diffuse large B-cell lymphoma. We consider choice and number of cycles of chemotherapy, the indications for radiotherapy and discuss the need for central nervous system prophylaxis. We also provide a brief overview of the less commonly encountered histologic subtypes including marginal zone, follicular, Burkitt and breast implant associated anaplastic large cell lymphoma. We conclude with a suggested treatment approach and potential areas of future research.
Collapse
|